HomeMy WebLinkAbout0088530-HVAC (a/c) 10 CITY OP OSHKOSH No 88530
OSHKOSH HVAC PERMIT APPLICATION AND RECORD
ON THE WATER
Job Address 1820 WINCHESTER AVE Owner RICHARD D CONNERS Create Date 05/24/2001
Contractor RASMUSSEN'S HEATING A/C INC Category 501 Residential -Air Conditioning Plan
Fuel 11 Gas I Oil 1 Electric 1 Solar 1 Solid
System n New 1 n Replace I ri Other
Li Forced Air U Radiant U Steam u NC u Vent
Electric 1 Hot Water Suppl. Con. Burner
Chimney Type Chimney A Chimney B 0 Direct Vent Not Applicable
Heat Loss As Approved Existing O Not Applicable Value
BTU Rate 0 As Per Plan 0 Variable Other Value 2 Ton
Use /Nature SFR INSTALL NEW 2 TON A/C
of Work (No electric permit required received installation verification signed by Hoehne Electric)
Fees: Valuation $1,300.00 Plan Approval $0.00 Permit Fee Paid $24.50
Issued By: Date 08/21/2001
Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 5154 DAVID DR OSHKOSH WI 54904 -0 Telephone Number 920 235 -6569
May 22 01 09:16p Scott Noe 920 232 0455 p.1
Y Division of Inspection Services
215 Church Avenue
P.O. Box I130
Oshkosh, Sir 54903 -1130
Fax (920) 236 -5084
c w� Phone (920) 236 -5048
HVAC PERMIT APPLICATION
All fields /information after bold categories must be provided.
Incomplete applications will not be. processed.
DATE 5 -0 k
JOB ADDRESS /8010 3 vN C VIC.S+C r
OWNER B c e.Y9.,r�. [.pin (Icy s
CONTRACTOR Rv.Sirn:,a r, S i- macc..
CIRCLE ALL APPLICABLE
USE CATEGORY INGL F AMILY DUPLEX MULTI FAMILY COMMERCIAL INDUSTRIAL
FUEL GAS OIL ELECTRIC SOLAR SOLID
SYSTEM 4120 REPLACE OTHER
TYPE FORCED AI RADIANT STEAM VENT
ELECTRIC HOT WATER SUPPL. CON. BURNER
IS CHIMNEY BEING LINED NO LINER SIZE MANUFACTURER
Note: All chimneys shall be sized per the BTU's being vented_
CHIMNEY TYPE NA. CHIMNEY A CHIMNEY B DIRECT VENT OTHER
HEAT LOSS AS APPROVED- EXISTING NOT APPLICABLE
BTU RATE AS PER PLAN VARIABLE- OTHER VALUE 2 TO h3
NATURE OF WORK: 1 n b Aft:
VALUE (Including labor and materials) 1 3O
ELECTRICAL CONTRACTOR 1 El Ct. r
Electrical installation of new /replacement equipment shall be done by licensed
contractors.
Valuation Fees
$0 to $1,000.00 ----------------------..$20.00
$1,000.01 to $10,000.00 ....$20.00 for first
$1,000.00 plus $1.50 per $100.00 valuation or part thereof
$10,000.01 to $25, 0 -00 .00.. _.._._..$155.00 for first
$10,000.00 plus $1.00 per $100.00 valuation or part thereof
Over $25,000.00 ---________$305.00 plus $0.50
per $100.00 valuation or part thereof
Submit payment with application. Failure to pay within -30 days will result in
fees being doubled or $100.00 plus the normal permit fee, which ever is
greater.
May 22 01 09:17p Scott Noe 920 232 -0455 p.2
cater of Odle*
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Maw 1130
Oshhesh WI iiw
an na viand ram 920-236- 9064
Electric Installation Verification
(n (we) 14oE hhe, (Electrical Contractor Name)
621 E. Owtar;0 6Mrri W 5'
(Address) (City) (State) (Zip Code)
have been contracted to perfonn electric installation work for Rek s w ssc.rt `s H VA c_..
(Name of party contracted to)
at the following addiesr QaO J r, arcs i
(Address where work will be performed)
The nature of the work consists of (Check One or Describe the Nature of Work)
x Reconnection or new circuit for replacement Heating Plant andror A/C Condenser.
Reconnection or new circuit for replant Electric Water Heater.
Reconnection of the Service Entrance Cable, Meter Box, alterations to receptacles and
lighting fixtures due to siding soffit moon. Note: New Service Entrance
Cables will require a separate pmt.
Reconnection or new circuit for other permanently wired appliances fixtures.
Other
The value of this work is 1 SO-
I hereby verify this work will be performed by an employee of this company and further verify the
reconnection installation will be done in compliance with manufacturer and Electric code
requirements.
(Signature of Company Officer) (Print Name of Officer) (Date)